Thank you so much for your highly informative article on hypertension for seniors–the best one that I have read. Presently, my wife, age 78, weight 98 lbs., height 4′ 11″, has been on a 4 m Atacand (brand name) per day for close to ten years now. Healthwise, I was concerned about its side effects on her. Pricewise, it is a very, very costly drug and our plan now requires her to pay a newly required deductible of $350 before reaching a new copay that has also become more expensive as well. She does not smoke or drink. Her family doctor has suggested that she switches to a generic brand Atacand but she prefers not to risk with its poorer bioavailability. Is such a preference valid? Are there any benefits in a generic that would outweigh its bioavailability constraint? Is there any alternative brand name drug that would offer her a good transition? Thank you kindly again for sharing the above highly informative, useful, and rare article regarding hypertension for seniors. I’d look forward to your reply with great appreciation–if I may. 

Don’t assume that your doctor is aware of these facts. If you are diagnosed with mild, high blood pressure, you likely will be prescribed medication, instructed that it is helpful, and told that you must take it for the rest of your life. But before accepting this potentially dangerous treatment, it may be to your advantage to seek answers to the following questions: “What caused my high blood pressure?” and “Can I remove those causes and reverse this condition?”
In most cases where high blood pressure is diagnosed, the cause remains unclear. One review paper in the International Journal of Hypertension explains that this accounts for around 90% of all hypertension diagnosis and is usually referred to as essential hypertension. Secondary hypertension is diagnosed when a cause can be identified. Potential causes of secondary hypertension may include:

Well, it sounds like you started with one BP med in the angiotensin II receptor blocker (ARB) class, and then your doctor switched you to another drug in that same class. These drugs do affect potassium, which can affect muscle function but otherwise, I haven’t heard of them being particularly associated with joint pain, and I didn’t see much mention of this when I looked just now in my clinical reference (Uptodate.com).

When was the last time you thought about your blood pressure? If you're like most people, it probably hasn't been since your doctor mentioned it during your last checkup. But high blood pressure (hypertension) is a serious condition that can lead to life-threatening problems, like heart attack and stroke. The good news is that you can lower your risk of hypertension with lifestyle changes.
2. Ayurveda Die: Improper diet also contributes towards the unhealthy condition of the body. Eat a balanced diet and avoid the consumption of salt and sugar, pickles, alcohol, caffeine, tomatoes, and fatty foods to regulate high BP. Include ginger, green leafy veggies, yogurt, berries, oatmeal, onion, amla, Omega-3 fatty acid, beetroot, Vitamin C rich fruits, herbs, garlic, seeds, cucumber, bananas, pomegranate, nuts, avocados and olive oil, in your meals.
Note: The fasting and high blood pressure study described in this article was funded in part by a grant from the National Health Association. It was conducted at the Center for Conservative Therapy in Penngrove, California. The results appeared in the article, “Medically Supervised Water-Only Fasting in the Treatment of Hypertension,” published in June 2001 in the Journal of Manipulative and Physiological Therapeutics.
The right tunes can help bring your blood pressure down, according to Italian research. Researchers asked 29 adults who were already taking BP medication to listen to soothing classical, Celtic, or Indian music for 30 minutes daily while breathing slowly. When they followed up with the subjects six months later, their blood pressure had dropped by an average of 4 mmHg.
If you have ever been in a hot tub with the “jets” on, you have observed a circulating system. When the pump is “on,” the water circulates from the hot tub, through pipes, into a pump, and then back to the hot tub. In this way, the water can be put through a filter to remove impurities and be re-utilized again and again. A hot tub with its pump “on” is a simple circulatory system. When the pump is “off,” the water stops circulating and stays wherever it is in the system.
If you suddenly find yourself with high blood pressure (hypertension) under the new guidelines from the American Heart Association and the American College of Cardiology, you might be wondering what to do. The guidelines, which were released in November, lowered the definition for high blood pressure to 130/80 from 140/90 millimeters of mercury (mm Hg), meaning more women now meet the criteria for stage 1 hypertension.
I would not recommend changing BP medications every 3-4 months just to prevent the onset of potential side-effects, but it certainly makes sense to reassess how you are doing on a BP med after a certain interval (usually after a few weeks, and then every few months or more often if the dose still needs to be refined or if there is concern about potential side-effects).
Reduce your fat and sugar intake: Maintaining a healthy weight for your body type helps keep blood pressure under control. It has been proven that losing excess weight can drastically lower blood pressure values. When obesity and hypertension are coupled together, it can lead to some dangerous long-term health effects that could eventually be fatal in the long run. It is estimated that about 36.5 Americans are obese, with the consumption of excessive amounts of sugar being the main culprit. It is important to make weight loss a priority when treating your high blood pressure.
Arteries are naturally flexible and smooth, which allows blood to easily move throughout the body. High blood pressure creates extra force against the artery walls, which damages the lining of the arteries. As they become narrower and harder, this restricts blood flow, and when blood flow is lowered, the heart has to work harder to pump it through the body, which only makes the problem worse.
Blood pressure fluctuates throughout the day, so measuring it in the morning might yield a different number than, say, the afternoon. Conditions like stress and lack of sleep can also fluctuate blood pressure. Visiting your doctor might feel nerve-wracking, which can elevate your blood pressure and create a condition called white coat hypertension.
In today’s time, when stress walks along, practicing poor eating habits combined with a sedentary lifestyle only add to the wellness issues. We prioritize our work, responsibilities and daily chores, and these things gradually tyrannize our life. Amidst pressure and hectic schedule, our health is something that suffers a lot. Stress and tension pave way for many ailments and to start with, high BP is the most common by far.
The main thing that strikes me about your comment is that you are taking three different BP medications. This is necessary for some people, but in other cases, with a little tinkering we are able to provide adequate control with just two medications. The combination of an ACE inhibitor (such as lisinopril) and a calcium channel blocker (such as amlodipine) was shown to be particularly favorable in the ACCOMPLISH trial, so this combination is now recommended by many experts.
According to the American College of Cardiology and the American Heart Association, the goal of blood pressure treatment is to attain a blood pressure reading that's less than 130/80 mmHg systolic and less than 80mmHg diastolic. In general, if you have hypertension, it is likely that you will need to be treated for the duration of your life to maintain this target blood pressure. 
Ocean Robbins is the author of 31-Day Food Revolution: Heal Your Body, Feel Great, and Transform Your World (Grand Central Life & Style, February 5, 2019). He is the CEO and co-founder of the 500,000+ member Food Revolution Network. He's served as the adjunct professor for Chapman University. And he's received numerous awards, including the national Jefferson Award for Outstanding Public Service and the Freedom's Flame Award. Ocean Robbins

It’s a common question among our guests at the Pritikin Longevity Center, who are taught how devastating the high-salt U.S. diet is to our blood pressure and overall health. Searching for alternatives, people often ask: What about salt substitutes with potassium? And what about MSG? Isn’t it a bad choice? Here are answers, some of which may surprise you.
People with high blood pressure who drank about eight ounces of beetroot juice experienced a decrease in blood pressure of about 10 mm Hg, according to a study published in April 2013 in the American Heart Association journal Hypertension. The magic ingredient? Nitrate, which turns into nitric oxide, a gas that widens blood vessels and aids blood flow. A glass a day could help keep blood pressure at a lower, healthier level. Here are 31 things you can do right now to avoid high blood pressure.
Next day I went to a doctor, my reading was 145/94, he ordered a blood test, renal functions and other things and cholesterol level; he put me on a mild ACE inhibitor-10mg. He told me I have essential hypertension and didn’t advise any dietary/lifestyle changes except for lower sodium intake. I’m fit, workout every other day and I’m vegetarian for more than 20 years.
Consider once again the analogy of the garden hose. If you turn on the water “harder,” there is more pressure in the hose. Excessive salt in the diet can result in excessive fluid volume in the blood, which results in elevated blood pressure. This cause, too, is reversible, as a plant-based diet of whole, natural foods, devoid of added salt, is naturally low in sodium chloride.
Knowing how to lower blood pressure fast is very important. Uncontrolled high blood pressure can cause irreversible damage to internal organs and shorten your life. When starting anything new please consult your primary care physician. With natural ways to lower your blood pressure always check to see if they will interfere with any current medication, you are taking. You can speak with your local pharmacist.
The American Heart Association considers 120/80 to be a normal blood pressure reading. Unless you have been diagnosed with high blood pressure you may not realize anything is wrong so it is important to get tested each time you see your doctor, or more frequently if you have a family history of hypertension. Often, hypertension has no obvious symptoms, but it could be quietly causing damage and threatening your health. This condition overworks the heart and damages the walls of the blood vessels. If left untreated, it can lead to tears, ruptures, or increased plaque build-up in your heart, which increases your risk for heart failure, heart attack or stroke.
One drink counts as 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of spirits. "High levels of alcohol are clearly detrimental," says Obarzanek. "But moderate alcohol is protective of the heart. If you are going to drink, drink moderately." (And if you're trying to keep your weight in check, stick to these low-calorie alcoholic drinks recommended by registered dietitians.)
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